Table. Characteristics of Patients Presenting With AMI and Cardiogenic Shock With Multivessel Coronary Artery Diseasea.
| Characteristic | Total (N = 64 301) | Multivessel PCI | P value | |
|---|---|---|---|---|
| No (n = 41 883) | Yes (n = 22 418) | |||
| Demographics | ||||
| Patient age, mean (SD), y | 66.4 (12.5) | 66.6 (12.4) | 65.9 (12.6) | <.001 |
| Age >70 y | 23 879 (37.1) | 15 832 (37.8) | 8047 (35.9) | <.001 |
| Female | 20 366 (31.7) | 13 297 (31.8) | 7069 (31.5) | .58 |
| Race/ethnicity | ||||
| White | 54 538 (84.8) | 35 671 (85.2) | 18 867 (84.2) | <.001 |
| Black | 5388 (8.4) | 3542 (8.5) | 1846 (8.2) | |
| Other | 4375 (6.8) | 2670 (6.4) | 1705 (7.6) | |
| BMI, mean (SD) | 28.65 (6.4) | 28.53 (6.4) | 28.87 (6.5) | <.001 |
| History | ||||
| Hypertension | 46 027 (71.6) | 29 916 (71.4) | 16 111 (71.9) | .24 |
| Diabetes | 21 126 (32.9) | 13 279 (31.7) | 7847 (35.0) | <.001 |
| Non–insulin-dependent diabetes | 11 553 (18.0) | 7510 (17.9) | 4043 (18.0) | |
| Insulin-dependent diabetes | 9573 (14.9) | 5769 (13.8) | 3804 (17.0) | |
| GFR, mean (SD), mL/min/1.73 m2 | 60.5 (31.7) | 60.4 (32.5) | 60.6 (30.3) | .42 |
| Hemodialysis at presentation | 2621 (4.1) | 1456 (3.5) | 1165 (5.2) | <.001 |
| Cerebrovascular disease | 8110 (12.6) | 5270 (12.6) | 2840 (12.7) | .76 |
| Peripheral arterial disease | 7700 (12.0) | 4909 (11.7) | 2791 (12.5) | .001 |
| Chronic lung disease | 10 056 (15.6) | 6590 (15.7) | 3466 (15.5) | .36 |
| Active tobacco use | 21 466 (33.4) | 14 435 (34.5) | 7031 (31.4) | <.001 |
| Dyslipidemia | 37 688 (58.6) | 24 276 (58.0) | 13 412 (59.8) | <.001 |
| Family history of premature CAD | 8650 (13.5) | 5711 (13.6) | 2939 (13.1) | .06 |
| MI | 14 583 (22.7) | 9240 (22.1) | 5343 (23.8) | <.001 |
| Heart failure | 9263 (14.4) | 5549 (13.3) | 3714 (16.6) | <.001 |
| Valve surgery or procedure | 479 (0.7) | 304 (0.7) | 175 (0.8) | .44 |
| PCI | 14 258 (22.2) | 9036 (21.6) | 5222 (23.3) | <.001 |
| Catheterization laboratory visit | ||||
| CAD presentation | <.001 | |||
| STEMIb | 48 943 (76.1) | 33 549 (80.1) | 15 394 (68.7) | |
| Anginal classification within 2 wk | ||||
| No symptoms | 7945 (12.4) | 5389 (12.9) | 2556 (11.4) | <.001 |
| CCS I | 470 (0.7) | 325 (0.8) | 145 (0.7) | |
| CCS II | 1339 (2.1) | 909 (2.2) | 430 (1.9) | |
| CCS III | 6481 (10.1) | 4146 (9.9) | 2335 (10.4) | |
| CCS IV | 47 897 (74.5) | 30 998 (74.0) | 16 899 (75.4) | |
| NA or missing | 169 (0.3) | 116 (0.3) | 53 (0.2) | |
| Antianginal medication within 2 wk | 28 649 (44.6) | 18 193 (43.4) | 10 456 (46.6) | <.001 |
| Heart failure within 2 wkb | 20 382 (31.7) | 11 787 (28.1) | 8595 (38.3) | <.001 |
| NYHA class within 2 wk | ||||
| Class I | 634 (1.0) | 413 (1.0) | 221 (1.0) | <.001 |
| Class II | 1835 (2.9) | 1162 (2.8) | 673 (3.0) | |
| Class III | 4084 (6.4) | 2487 (5.9) | 1597 (7.1) | |
| Class IV | 13 742 (21.4) | 7675 (18.3) | 6067 (27.1) | |
| NA or missing | 44 006 (68.4) | 30 146 (72.0) | 13 860 (61.8) | |
| Cardiomyopathy or left ventricular systolic dysfunctionb | 14 011 (21.8) | 8079 (19.3) | 5932 (26.5) | <.001 |
| Intra-aortic balloon pumpb | 31 814 (49.5) | 19 923 (47.6) | 11 891 (53.0) | <.001 |
| Other mechanical circulatory support devicesb | 1770 (9.8) | 933 (7.5) | 837 (14.6) | <.001 |
| Coronary anatomyc | ||||
| Left main | 8962 (13.9) | 4098 (9.8) | 4864 (21.7) | <.001 |
| LAD | 49 765 (77.4) | 30 787 (73.5) | 18 978 (84.7) | <.001 |
| LCX | 40 365 (62.8) | 24 304 (58.0) | 16 061 (71.6) | <.001 |
| RCA | 47 052 (73.2) | 31 675 (75.6) | 15 377 (68.6) | <.001 |
| PCI procedure | ||||
| Pre-PCI left ventricular ejection fraction, mean (SD), % | 34.87 (15.5) | 36.18 (15.6) | 32.73 (15.1) | <.001 |
| NA or missing | 36 585 (56.9) | 24 703 (59.0) | 11 882 (53.0) | <.001 |
| Highest-risk lesion or culprit vesseld | ||||
| Proximal RCA, mid LAD, and proximal LCX | 24 611 (38.3) | 17 412 (41.6) | 7199 (32.1) | <.001 |
| Proximal LAD | 19 522 (30.4) | 11 226 (26.8) | 8296 (37.0) | |
| Left main | 6180 (9.6) | 1375 (3.3) | 4805 (21.4) | |
| Other | 13 833 (21.5) | 11 715 (28.0) | 2118 (9.5) | |
| Unknown | 155 (0.2) | 155 (0.4) | 0 (0.0) | |
| Additional revascularization | ||||
| Subsequent PCI during hospitalization | 5150 (8.0) | 1206 (2.9) | 3944 (17.6) | <.001 |
| CABG during hospitalization | 4443 (6.9) | 3733 (8.9) | 710 (3.2) | <.001 |
| Hospital disposition | ||||
| In-hospital death | 23 159 (36.0) | 15 049 (35.9) | 8110 (36.2) | <.001 |
| Home | 26 356 (41.0) | 17 241 (41.2) | 9115 (40.7) | |
| Extended care and rehabilitation | 6310 (9.8) | 3939 (9.4) | 2371 (10.6) | |
| Other acute care hospital | 4902 (7.6) | 3339 (8.0) | 1563 (7.0) | |
| Nursing home | 1968 (3.1) | 1239 (3.0) | 729 (3.3) | |
| Hospice | 1216 (1.9) | 825 (2.0) | 391 (1.7) | |
| Other | 204 (0.3) | 123 (0.3) | 81 (0.4) | |
| Left against medical advice | 186 (0.3) | 128 (0.3) | 58 (0.3) | |
Abbreviations: AMI, acute myocardial infarction; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); CABG, coronary artery bypass graft; CAD, coronary artery disease; CCS, Canadian Cardiovascular Society; GFR, glomerular filtration rate; LAD, left anterior descending artery; LCX, left circumflex artery; MI, myocardial infarction; NA, not applicable; NYHA, New York Heart Association; PCI, percutaneous coronary intervention; RCA, right coronary artery; SCAI, Society for Cardiovascular Angiography and Interventions; STEMI, ST-segment elevation MI.
a
Data are presented as number (percentage) of patients unless otherwise indicated.
b
Characteristics with standardized differences exceeding 10%.
c
Lesion in coronary artery was classified as obstructive at 50% stenosis or more for left main artery and 70% stenosis or more of other vessels.
d
Highest degree of stenosis and lesion complexity.